Experts educate residents on cumbersome healthcare reform

Thousands of uninsured Western North Carolina residents will soon benefit from the Affordable Care Act, despite most people still being confused over what health insurance reform truly entails, according local health experts.

A public meeting in Sylva Monday night brought together a panel of doctors, health care administrators and community organizers to answer questions and explain some of the pending changes coming under Obamacare.

Starting Oct. 1, Internet health care exchanges around the country will go live, allowing millions of uninsured Americans to shop healthcare plans online. Those plans will go into effect in 2014.

As a way to make health insurance more affordable, the act provides tax credits to most people for buying insurance and sets out minimum standards for what insurance companies have to cover for people on a plan.

“And you cannot be denied for preexisting conditions, which is a biggie,” said Jane Harrison, preventative specialist with Mountain Projects, a nonprofit that administers aid and support for the needy, poor and disabled in Jackson and Haywood counties.

Mountain Projects is assembling a team of community “navigators,” as they’ve been deemed, with the help of federal grant money to assist residents wanting to enroll in a subsidized plan but are confused how to do so. It is one of several organizations doing the same.

Under the Affordable Care Act, preventative health measures are largely without a co-pay — from routine pap smears to annual physicals — placing an emphasis on screenings to catch illnesses early and get patients seen in the doctor’s office before they end up in the emergency room.

This is one of the aspects of the law Harrison is most excited about, after her son-in-law recently died at the age of 54 from a treatable form of cancer.

Adding scores of people to the rolls of insurance should help to avoid such tragic incidences. Nationwide, approximately 45,000 deaths per year are associated with a lack of healthcare, she said.

“It’s very important that we get to those people,” Harrison said. “That’s why the emphasis is on preventive care.”

The uninsured cracks

In WNC, an estimated 30,000 people are without health insurance, said Mountain Projects Executive Director Patsy Dowling.

Though Dowling acknowledged the Affordable Care Act is not perfect, she said it’s a step in the right direction in helping people access medicine and health care. Many people come to her organization desperate for help and unable to afford doctor’s visits or more serious healthcare needs.

“I’ve seen firsthand what happens when people don’t have adequate health care,” Dowling said. “I have seen some heartbreaking situations.”

For Jackson County resident Marsha Crites, her health care crisis came unexpectedly. More than 20 years ago, Crites had a cerebellar stroke that forced her to learn to walk and talk all over again.

“When I was 49 years old, life dealt me one of those blows nobody can predict,” she said.

Now 61, Crites has recovered, but her health crisis left her uninsurable with a pre-existing condition. She is hoping Obamacare will be able to get her insurance. The law prevents insurance companies from denying coverage to people like Crites, or who have cancer or diabetes.

“I am uninsurable because of what happened,” she said. “I’m very excited about the Affordable Care Act.”

The law also stops providers from charging women more for insurance than men, mandates insurance companies devote a minimum of 80 percent of premiums to health care and prevents lifetime caps on health benefits.

These are just some aspects of the law that have earned it the backing of professional medical organizations in the U.S., including American College of Physicians, the American Academy of Pediatrics, and the American Congress of Obstetricians and Gynecologists, said Dr. David Trigg, an ER doctor at Cherokee Indian Hospital and clinical director at the Good Samaritan Clinic.

As an emergency room doctor, Trigg is required to see every patient that walks in the door, regardless of his or her insurance situation.

And not having insurance makes you more likely to die, Trigg said.

That holds true even in young adults.

“Just being uninsured can be considered a risk factor,” he said. “Just like you’d consider high-blood pressure or smoking risk factors.”

But being uninsured is not only detrimental to a person’s health, it’s also rolling the dice when it comes to their pocketbook.

“Medical costs are the number one cause of bankruptcy in the United States,” Trigg said. “The uninsured are totally unprotected.”

On the other hand, Obamacare is also projected to leave more than 30 millions uninsured in its first year as lawmakers in states like North Carolina refuse to expand Medicaid to the poor and millions opt not to buy insurance. Which is why Becky Olson, executive director of the Good Samaritan Clinic in Jackson County, said her free clinic won’t be closing anytime soon.

It’s one of 81 free clinics registered in the state, attempting to pick up where the system fails.

“As proud and honored I am to be a part of this amazing organization, I know free clinics are not the best option for providing coordinated and continuous care,” she said. “None of us can provide all needed services all the times.”